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Mariano LSS, Nakamura-Silva R, Macedo LMDD, Oliveira-Silva MD, Goulart RDS, Pelisson M, Vespero EC, Silva-Sousa YTC, Pitondo-Silva A. Identification and antimicrobial susceptibility profile of bacteria isolated from primary endodontic infections. Braz Oral Res 2024; 38:e024. [PMID: 38597544 DOI: 10.1590/1807-3107bor-2024.vol38.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 10/03/2023] [Indexed: 04/11/2024] Open
Abstract
This study aimed to identify and characterize the antimicrobial susceptibility profile of bacteria found in primary endodontic infections in the teeth of patients treated at the Dental Clinic of the University of Ribeirão Preto, São Paulo, Brazil. From September to December 2019, samples were obtained from 21 patients with primary endodontic infections. The collections were carried out in triplicate using paper cones placed close to the total length of the root canal. Bacterial isolation was performed in Brain Heart Infusion agar, Blood agar, and other selective culture media cultured at 37°C for up to 48 h under aerobiosis and microaerophilic conditions. The bacterial species were identified using the Vitek 2 automated system. The disk diffusion method on agar Müeller-Hinton was used to assess antimicrobial susceptibility with the recommended antimicrobials for each identified bacterial species. A total of 49 antibiotics were evaluated. Fifteen of the 21 samples collected showed bacterial growth, and 17 bacterial isolates were found. There were 10 different bacterial species identified: Enterococcus faecalis (four isolates), Streptococcus mitis/oralis (three isolates), Streptococcus anginosus (three isolates) being the most common, followed by Staphylococcus epidermidis, Enterococcus faecium, Streptococcus constellatus, Streptococcus alactolyticus, Enterobacter cloacae, Klebsiella variicola, and Providencia rettgeri (one isolate of each species). The analysis demonstrated significant susceptibility to most of the tested antibiotics. However, some Enterococcus isolates resisted the antibiotic's erythromycin, ciprofloxacin, and tetracycline. A Staphylococcus epidermidis isolate was characterized as multidrug-resistant. Five Streptococcus isolates were non-susceptible to all antibiotics tested.
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Affiliation(s)
| | - Rafael Nakamura-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | | | - Mariana de Oliveira-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Environmental Technology, Universidade de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Rafael da Silva Goulart
- Universidade de Ribeirão Preto, Postgraduate Program in Dentistry, Ribeirão Preto, SP, Brazil
| | - Marsileni Pelisson
- Universidade Estadual de Londrina, Department of Pathology, Clinical and Toxicological Analysis, Londrina, PR, Brazil
| | - Eliana Carolina Vespero
- Universidade Estadual de Londrina, Department of Pathology, Clinical and Toxicological Analysis, Londrina, PR, Brazil
| | | | - André Pitondo-Silva
- Universidade de Ribeirão Preto, Postgraduate Program in Dentistry, Ribeirão Preto, SP, Brazil
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Tavares ER, de Lima TF, Bartolomeu-Gonçalves G, de Castro IM, de Lima DG, Borges PHG, Nakazato G, Kobayashi RKT, Venancio EJ, Tarley CRT, de Almeida ERD, Pelisson M, Vespero EC, Simão ANC, Perugini MRE, Kerbauy G, Fornazieri MA, Tognim MCB, Góes VM, de Souza TDACB, Oliveira DBL, Durigon EL, Faccin-Galhardi LC, Yamauchi LM, Yamada-Ogatta SF. Development of a Melting-Curve-Based Multiplex Real-Time PCR Assay for the Simultaneous Detection of Viruses Causing Respiratory Infection. Microorganisms 2023; 11:2692. [PMID: 38004704 PMCID: PMC10672821 DOI: 10.3390/microorganisms11112692] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
The prompt and accurate identification of the etiological agents of viral respiratory infections is a critical measure in mitigating outbreaks. In this study, we developed and clinically evaluated a novel melting-curve-based multiplex real-time PCR (M-m-qPCR) assay targeting the RNA-dependent RNA polymerase (RdRp) and nucleocapsid phosphoprotein N of SARS-CoV-2, the Matrix protein 2 of the Influenza A virus, the RdRp domain of the L protein from the Human Respiratory Syncytial Virus, and the polyprotein from Rhinovirus B genes. The analytical performance of the M-m-qPCR underwent assessment using in silico analysis and a panel of reference and clinical strains, encompassing viral, bacterial, and fungal pathogens, exhibiting 100% specificity. Moreover, the assay showed a detection limit of 10 copies per reaction for all targeted pathogens using the positive controls. To validate its applicability, the assay was further tested in simulated nasal fluid spiked with the viruses mentioned above, followed by validation on nasopharyngeal swabs collected from 811 individuals. Among them, 13.4% (109/811) tested positive for SARS-CoV-2, and 1.1% (9/811) tested positive for Influenza A. Notably, these results showed 100% concordance with those obtained using a commercial kit. Therefore, the M-m-qPCR exhibits great potential for the routine screening of these respiratory viral pathogens.
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Affiliation(s)
- Eliandro Reis Tavares
- Laboratory of Molecular Biology of Microorganisms, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (E.R.T.); (D.G.d.L.)
| | - Thiago Ferreira de Lima
- Graduate Program in Microbiology, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (T.F.d.L.); (I.M.d.C.); (P.H.G.B.); (G.N.); (R.K.T.K.); (L.C.F.-G.)
| | - Guilherme Bartolomeu-Gonçalves
- Graduate Program in Clinical and Laboratory Pathophysiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina 86038-350, Brazil; (G.B.-G.); (E.J.V.); (M.P.); (E.C.V.); (A.N.C.S.); (M.R.E.P.)
| | - Isabela Madeira de Castro
- Graduate Program in Microbiology, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (T.F.d.L.); (I.M.d.C.); (P.H.G.B.); (G.N.); (R.K.T.K.); (L.C.F.-G.)
| | - Daniel Gaiotto de Lima
- Laboratory of Molecular Biology of Microorganisms, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (E.R.T.); (D.G.d.L.)
| | - Paulo Henrique Guilherme Borges
- Graduate Program in Microbiology, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (T.F.d.L.); (I.M.d.C.); (P.H.G.B.); (G.N.); (R.K.T.K.); (L.C.F.-G.)
| | - Gerson Nakazato
- Graduate Program in Microbiology, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (T.F.d.L.); (I.M.d.C.); (P.H.G.B.); (G.N.); (R.K.T.K.); (L.C.F.-G.)
| | - Renata Katsuko Takayama Kobayashi
- Graduate Program in Microbiology, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (T.F.d.L.); (I.M.d.C.); (P.H.G.B.); (G.N.); (R.K.T.K.); (L.C.F.-G.)
| | - Emerson José Venancio
- Graduate Program in Clinical and Laboratory Pathophysiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina 86038-350, Brazil; (G.B.-G.); (E.J.V.); (M.P.); (E.C.V.); (A.N.C.S.); (M.R.E.P.)
| | | | | | - Marsileni Pelisson
- Graduate Program in Clinical and Laboratory Pathophysiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina 86038-350, Brazil; (G.B.-G.); (E.J.V.); (M.P.); (E.C.V.); (A.N.C.S.); (M.R.E.P.)
| | - Eliana Carolina Vespero
- Graduate Program in Clinical and Laboratory Pathophysiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina 86038-350, Brazil; (G.B.-G.); (E.J.V.); (M.P.); (E.C.V.); (A.N.C.S.); (M.R.E.P.)
| | - Andrea Name Colado Simão
- Graduate Program in Clinical and Laboratory Pathophysiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina 86038-350, Brazil; (G.B.-G.); (E.J.V.); (M.P.); (E.C.V.); (A.N.C.S.); (M.R.E.P.)
| | - Márcia Regina Eches Perugini
- Graduate Program in Clinical and Laboratory Pathophysiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Londrina 86038-350, Brazil; (G.B.-G.); (E.J.V.); (M.P.); (E.C.V.); (A.N.C.S.); (M.R.E.P.)
| | - Gilselena Kerbauy
- Graduate Program in Nursing, Department of Nursing, State University of Londrina, Londrina 86038-350, Brazil;
| | - Marco Aurélio Fornazieri
- Graduate Program in Health Sciences, Department of Clinical Surgery, State University of Londrina, Londrina 86038-350, Brazil;
| | | | | | | | - Danielle Bruna Leal Oliveira
- Albert Einstein Hospital, São Paulo 05652-900, Brazil;
- Laboratory of Clinical and Molecular Virology, University of São Paulo, São Paulo 05508-000, Brazil;
| | - Edison Luiz Durigon
- Laboratory of Clinical and Molecular Virology, University of São Paulo, São Paulo 05508-000, Brazil;
| | - Lígia Carla Faccin-Galhardi
- Graduate Program in Microbiology, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (T.F.d.L.); (I.M.d.C.); (P.H.G.B.); (G.N.); (R.K.T.K.); (L.C.F.-G.)
| | - Lucy Megumi Yamauchi
- Laboratory of Molecular Biology of Microorganisms, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (E.R.T.); (D.G.d.L.)
- Graduate Program in Microbiology, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (T.F.d.L.); (I.M.d.C.); (P.H.G.B.); (G.N.); (R.K.T.K.); (L.C.F.-G.)
| | - Sueli Fumie Yamada-Ogatta
- Laboratory of Molecular Biology of Microorganisms, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (E.R.T.); (D.G.d.L.)
- Graduate Program in Microbiology, Department of Microbiology, State University of Londrina, Londrina 86057-970, Brazil; (T.F.d.L.); (I.M.d.C.); (P.H.G.B.); (G.N.); (R.K.T.K.); (L.C.F.-G.)
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da Silva RS, Duarte FC, Danelli T, Olak APS, Magalhães GLG, Pelisson M, Cardim SL, Gonçalves GB, Vespero EC, Tavares ER, Yamauchi LM, Perugini MRE, Yamada-Ogatta SF. High Prevalence of Panton-valentine Leukocidin-encoding Genes in Methicillin-resistant Staphylococcus aureus Isolated from Inpatients with Invasive Infections at a University Hospital in Southern Brazil. Infect Disord Drug Targets 2023; 23:37-45. [PMID: 36125822 DOI: 10.2174/1871526522666220823164600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/13/2022] [Accepted: 06/30/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Staphylococcus aureus is a major cause of a wide diversity of infections in humans, and the expression of Panton-Valentine Leukocidin (PVL) has been associated with severe clinical syndromes. OBJECTIVES The present study aimed to investigate the prevalence of PVL-encoding genes in S. aureus isolated from clinical samples of inpatients with invasive infections in a teaching hospital in Southern Brazil. Furthermore, phenotypic and genotypic characteristics of bacterial isolates were analyzed. METHODS A total of 98 S. aureus isolates recovered from different body sites were characterized according to their antimicrobial susceptibility profile, methicillin-resistance and SCCmec typing, genetic relatedness and occurrence of virulence-encoding genes, such as icaA, lukS-PV/lukF-PV, and tst. RESULTS Sixty-eight (69.4%) isolates were classified as methicillin-resistant, and among them, four (5.9%) did not harbor the mecA gene. The mecA-harboring methicillin-resistant S. aureus (MRSA) isolates were grouped into SCCmec types I (6.3%), II (64.1%), III (6.3%), IV (15.6%), V (4.7%), and VI (1.6%). One isolate (1.6%) was classified as non-typeable (NT). Seventy isolates (71.4%) were classified as multidrug-resistant. The overall prevalence of virulence-encoding genes was as follows: icaA, 99.0%; tst, 27.5%; and lukS-PV/lukF-PV, 50.0%. The presence of tst gene was significantly higher (p < 0.001) in methicillin-susceptible S. aureus (MSSA) compared to MRSA isolates. CONCLUSION The present study reports a high prevalence of multidrug-resistant S. aureus harboring lukS-PV/lukF-PV and tst genes in invasive infections. The continuous monitoring of the antimicrobial susceptibility profile and virulence of S. aureus is an important measure for the control of infections caused by this bacterium.
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Affiliation(s)
- Raquel Soares da Silva
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Felipe Crepaldi Duarte
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Tiago Danelli
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Anna Paula Silva Olak
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Gerusa Luciana Gomes Magalhães
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Marsileni Pelisson
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Stefani Lino Cardim
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Guilherme Bartolomeu Gonçalves
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Eliana Carolina Vespero
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | | | - Lucy Megumi Yamauchi
- Departamento de Microbiologia, Programa de Pós-graduação em Microbiologia, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Marcia Regina Eches Perugini
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Sueli Fumie Yamada-Ogatta
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Programa de Pós-graduação em Fisiopatologia Clínica e Laboratorial, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, Paraná, Brazil.,Departamento de Microbiologia, Programa de Pós-graduação em Microbiologia, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
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Soares de Moraes L, Gomes Magalhaes GL, Material Soncini JG, Pelisson M, Eches Perugini MR, Vespero EC. High mortality from carbapenem-resistant Klebsiella pneumoniae bloodstream infection. Microb Pathog 2022; 167:105519. [PMID: 35483557 DOI: 10.1016/j.micpath.2022.105519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/18/2022]
Abstract
In this study, it was evaluated clinical data of 107 patients with bloodstream infection (BSI) by Klebsiella pneumoniae and performed phenotypic and molecular analyzes in 50.5% (54/107) of the samples, those that showed a resistance profile to carbapenemics. The blaKPC gene was present in 90.4% (49/54) of the samples, blaNDM gene in one sample and, in 7.4% (4/54) of the samples, no carbapenemase gene was found. In the similarity analysis, it was found 4 main clones and 11 samples were not genetically related. The median age of the patients was 58 (40-70) years old and 60.7% (65/107) were male. When comparing two groups of patients with BSI due to K. pneumoniae with and without resistance to carbapenems, the variables ICU permanence, renal failure (IR), previous use of antimicrobials, Charlson's comorbidity index (ICCi), some invasive procedures and death showed a statistically significant difference (p < 0.05). And when relating death as a dependent variable, IR, liver failure and patients with BSI XDR or PDR, were predictors of increased mortality. Our study showed a higher mortality rate in patients with BSI due to carbapenem-resistant pneumonia with additional resistance or not to polymyxins.
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Affiliation(s)
- Luana Soares de Moraes
- Clinical and Laboratory Microbiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Paraná, Brazil
| | - Gerusa Luciana Gomes Magalhaes
- Clinical and Laboratory Microbiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Paraná, Brazil
| | - João Gabriel Material Soncini
- Clinical and Laboratory Microbiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Paraná, Brazil
| | - Marsileni Pelisson
- Clinical and Laboratory Microbiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Paraná, Brazil
| | - Marcia Regina Eches Perugini
- Clinical and Laboratory Microbiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Paraná, Brazil
| | - Eliana Carolina Vespero
- Clinical and Laboratory Microbiology, Department of Pathology, Clinical and Toxicological Analysis, State University of Londrina, Paraná, Brazil.
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Sakai AM, Iensue TNAN, Pereira KO, De Souza NAA, Silva CM, Salvador MSDA, Rodrigues R, Capobiango JD, Pelisson M, Vespero EC, Lioni LMY, Perugini MRE, Ogatta SFY, Rossetto EG, Kerbauy G. Colonization by multidrug-resistant microorganisms of hospitalized newborns and their mothers in the neonatal unit context. J Infect Dev Ctries 2020; 14:765-771. [PMID: 32794468 DOI: 10.3855/jidc.12091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 05/18/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The mother plays a fundamental role in the constitution and regulation of her child's healthy microbiota, however, preterm newborns are separated from their mothers soon after birth and transferred to Neonatal Intensive Care Units, being exposed the constant risk for the development of multidrug-resistant microorganisms' infections. The aim of this study was to explore the multidrug-resistant microorganism colonization of hospitalized babies and their mothers in the neonatal unit context. METHODOLOGY A prospective case study conducted with hospitalized babies and their mothers in the Neonatal Unit at a university hospital. The sample was composed of 433 binomials (mother-child). Colonization culture samples were taken at the moment of the baby's discharge, via two swabs in the oral, nasal, axillary, inguinal, and rectal regions. RESULTS The colonization incidence among the binomials, 30 (6.9%) were both colonized by multi-resistant microorganisms. Mothers of colonized babies (24.4%) demonstrated a higher chance of colonization in comparison to mothers of non-colonized babies (11.9%) (p = 0.002). Relationships were drawn between baby colonization and prematurity, extremely low birth weight, and non-exclusive maternal breastfeeding (p<0.05). ESBL-producing Gram-negative microorganisms were more frequent in the cultures of the binomials, with 35.9% of the babies colonized with Klebsiella spp. ESBL and 42.0% of the mothers with Escherichia coli ESBL. Furthermore, 50% of the binomials were colonized with E. coli ESBL. CONCLUSION The prematurity, extremely low birth weight, and non-exclusive breastfeeding at hospital discharge were associated with baby colonization by multidrug-resistant microorganism. Furthermore, mothers of colonized children presented higher chances of colonization.
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Affiliation(s)
- Andressa Midori Sakai
- Departamento de Enfermagem, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | | | - Kauana Olanda Pereira
- Departamento de Enfermagem, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | | | - Claudineia Maria Silva
- Laboratório de Microbiologia, Hospital Universitário, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | - Marta Silva de Almeida Salvador
- Departamento de Microbiologia, Laboratório de Ecologia Microbiana, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | - Renne Rodrigues
- Departamento de Saúde Coletiva, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | - Jaqueline Dario Capobiango
- Departamento de Pediatria e Cirurgia Pediátrica, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | - Marsileni Pelisson
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | - Eliana Carolina Vespero
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | | | - Marcia Regina Eches Perugini
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
| | | | | | - Gilselena Kerbauy
- Departamento de Enfermagem, Universidade Estadual de Londrina, Londrina, Paraná, Brasil.
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Sakai AM, Iensue TNAN, Pereira KO, Silva RLD, Pegoraro LGDO, Salvador MSDA, Rodrigues R, Capobiango JD, Souza NAAD, Pelisson M, Vespero EC, Yamauchi LM, Perugini MRE, Yamada-Ogatta SF, Rossetto EG, Kerbauy G. Colonization profile and duration by multi-resistant organisms in a prospective cohort of newborns after hospital discharge. Rev Inst Med Trop Sao Paulo 2020; 62:e22. [PMID: 32236389 PMCID: PMC7178810 DOI: 10.1590/s1678-9946202062022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 02/18/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine the spontaneous decolonization period and characteristics in a prospective cohort of newborns colonized by multidrug-resistant organisms, after their discharge from the neonatal intensive care unit. Multidrug resistance is defined as bacterial non-susceptibility to ≥ 1 agent of ≥ 3 antimicrobial categories. In total, 618 newborns were included in the study, of which 173 (28.0%) presented a positive culture for multidrug-resistant microorganisms, and of these, 52 (30.1%) were followed up in this study. The most frequent intrinsic factors were be born by cesarean section (86.5%), prematurity (84.6%), and very low birth weight (76.9%). The extrinsic factors were having remained hospitalized for an average of 27 days, during which 67.3% were submitted to invasive procedures and 88.5% received antimicrobials. The intrinsic and extrinsic factors of newborns were not associated to a decolonization period longer or shorter than 3 months, which was the average period of decolonization found in the present study. From the totality of colonization cultures sampled at hospital discharge, the Gram-negative Extended Spectrum β-lactamase producing bacteria were the most common, with 28.9% of babies colonized by Klebsiella spp. The median period of decolonization by multidrug-resistant microorganisms in the newborns population after hospital discharge was 3 months, but was highly dependent on the microbial species, and this period was not associated to any intrinsic and extrinsic factors of the newborn.
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Affiliation(s)
- Andressa Midori Sakai
- Universidade Estadual de Londrina, Departamento de Enfermagem, Londrina, Paraná, Brazil
| | | | - Kauana Olanda Pereira
- Universidade Estadual de Londrina, Departamento de Enfermagem, Londrina, Paraná, Brazil
| | - Renata Lima da Silva
- Universidade Estadual de Londrina, Departamento de Enfermagem, Londrina, Paraná, Brazil
| | | | - Marta Silva de Almeida Salvador
- Universidade Estadual de Londrina, Departamento de Microbiologia, Laboratório de Ecologia Microbiana, Londrina, Paraná, Brazil
| | - Renne Rodrigues
- Universidade Estadual de Londrina, Departamento de Saúde Coletiva, Londrina, Paraná, Brazil
| | - Jaqueline Dario Capobiango
- Universidade Estadual de Londrina, Departamento de Pediatria e Cirurgia Pediátrica, Londrina, Paraná, Brazil
| | | | - Marsileni Pelisson
- Universidade Estadual de Londrina, Departamento de Patologia, Análises Clínicas e Toxicológicas, Londrina, Paraná, Brazil
| | - Eliana Carolina Vespero
- Universidade Estadual de Londrina, Departamento de Patologia, Análises Clínicas e Toxicológicas, Londrina, Paraná, Brazil
| | - Lucy Megumi Yamauchi
- Universidade Estadual de Londrina, Departamento de Microbiologia, Londrina, Paraná, Brazil
| | - Marcia Regina Eches Perugini
- Universidade Estadual de Londrina, Departamento de Patologia, Análises Clínicas e Toxicológicas, Londrina, Paraná, Brazil
| | | | | | - Gilselena Kerbauy
- Universidade Estadual de Londrina, Departamento de Enfermagem, Londrina, Paraná, Brazil
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Daga AP, Koga VL, Soncini JGM, de Matos CM, Perugini MRE, Pelisson M, Kobayashi RKT, Vespero EC. Escherichia coli Bloodstream Infections in Patients at a University Hospital: Virulence Factors and Clinical Characteristics. Front Cell Infect Microbiol 2019; 9:191. [PMID: 31245301 PMCID: PMC6563721 DOI: 10.3389/fcimb.2019.00191] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/20/2019] [Indexed: 01/24/2023] Open
Abstract
Extraintestinal pathogenic Escherichia coli (ExPEC) isolates are responsible for many bloodstream infections. The aim of this study was to characterize E. coli isolated from the bloodstreams of patients (n = 48) at the University Hospital in Brazil. Epidemiological data were obtained through the analysis of medical records and laboratory tests. By PCR analysis, we investigated the presence of virulence factors (VFs), pathogenicity islands (PAIs), extended-spectrum β-lactamase (ESBL), phylogenetic classifications (A, B1, B2, C, D, E, and F) and molecular genotype by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR). The mortality analysis showed that 33.3% of the deaths were associated with bacteraemia due to E. coli infections; in addition, an age between 60 and 75 years (p < 0.001; OR = 6.3[2.1–18.9]) and bacteraemia with an abdominal origin (p = 0.02; OR = 5[1.2–20.5]) were risk factors for the severity of the infection. Additionally, the presence of the afa gene was associated with mortality due to E. coli bacteraemia (p = 0.027; OR = 11.4[1.5–85.7]). Immunosuppression (27.1%), intestinal diseases (25.0%) and diabetes (18.8%), were prevalent among patients, and most of the bacteraemia cases were secondary to urinary tract infections (50.0%). The serum resistance gene traT was present in 77.1% of isolates, group capsular 2 (kpsMT II) was present in 45.8% and the K5 capsule was present in 20.8% of isolates. The isolates also showed a high prevalence for the siderophore yersiniabactina (fyuA) (70.8%) and PAI IV536 (77.1%). Phylogenetic analysis showed that group B2 (45.8%) was the most prevalent, and was the phylogroup that had a higher prevalence of VFs and PAIs. However, in this study, a considerable number of isolated bacteria were classified as group B1 (18.8%) and as group E (14.6%). Eight (16.7%) isolates were resistant to third and fourth generation cephalosporin and group CTX-M-1 (CTX-M-15) was the most prevalent ESBL type. The molecular genotyping showed two clonal lineages and several isolates that were not related to each other. This study provides additional information on the epidemiological and molecular characteristics of E. coli bloodstream infections in Brazil.
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Affiliation(s)
- Ana Paula Daga
- Laboratory of Clinical Microbiology, Department of Pathology, Clinical and Toxicological Analysis, Health Sciences Center, State University of Londrina, Londrina, Brazil
| | - Vanessa Lumi Koga
- Laboratory of Microbiology, Department of Microbiology, State University of Londrina, Londrina, Brazil
| | - João Gabriel Material Soncini
- Laboratory of Clinical Microbiology, Department of Pathology, Clinical and Toxicological Analysis, Health Sciences Center, State University of Londrina, Londrina, Brazil
| | - Caroline Martins de Matos
- Laboratory of Clinical Microbiology, Department of Pathology, Clinical and Toxicological Analysis, Health Sciences Center, State University of Londrina, Londrina, Brazil
| | - Marcia Regina Eches Perugini
- Laboratory of Clinical Microbiology, Department of Pathology, Clinical and Toxicological Analysis, Health Sciences Center, State University of Londrina, Londrina, Brazil
| | - Marsileni Pelisson
- Laboratory of Clinical Microbiology, Department of Pathology, Clinical and Toxicological Analysis, Health Sciences Center, State University of Londrina, Londrina, Brazil
| | | | - Eliana Carolina Vespero
- Laboratory of Clinical Microbiology, Department of Pathology, Clinical and Toxicological Analysis, Health Sciences Center, State University of Londrina, Londrina, Brazil
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Morguette AEB, Biasi-Garbin RP, Otaguiri ES, Perugini MRE, Pelisson M, Carrara-Marroni FE, Vespero EC, Belei RA, Kerbauy G, Capobiango JD, Yamauchi LM, Yamada-Ogatta SF. Prevalence and antimicrobial susceptibility profile of Streptococcus agalactiae in pregnant women seen at the University Hospital of Londrina, Paraná, Brazil. Semin Cienc Biol Saude 2018. [DOI: 10.5433/1679-0367.2018v39n1p77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A retrospective study of pregnant women seen at the University Hospital of Londrina, Paraná, Brazil was performed to determine the prevalence of Group B Streptococcus (GBS) vaginal-rectal colonization, and the GBS susceptibility for antimicrobials used in intrapartum antibiotic prophylaxis. A vaginal-rectal swab was collected from 2,901 women between 35 and 37 weeks of gestation. Of these, 528 (18.2%) had a positive culture for GBS, and 0.4%, 10.2% and 10% of the isolates were resistant to penicillin, erythromycin and clindamycin, respectively. These results highlight the importance of continuous surveillance of GBS colonization in pregnant women for preventing GBS infections in neonates.
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Duarte FC, Danelli T, Ribeiro MAG, Perugini LF, Vespero EC, Carrara-Marroni FE, Pelisson M, Yamauchi LM, Yamada-Ogatta SF, Eches Perugini MR. Bacteremia causada por Staphylococcus aureus: Uma análise de quinze anos da sensibilidade a antimicrobianos em um hospital terciário do Brasil. Rev Epidemiol Control Infect 2018. [DOI: 10.17058/reci.v8i3.11245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Justificativa e Objetivo: Infecções da corrente sanguínea por Staphylococcus aureus constituem uma das principais causas de morbidade e mortalidade em todo mundo. O tratamento de infecções por S. aureus é complicado pela elevada prevalência de resistência a antimicrobianos. Compreender a epidemiologia e os padrões de resistência deste microrganismo é um ponto crítico para a prescrição empírica adequada de antimicrobianos. Desta maneira, este estudo teve por objetivo avaliar a evolução de resistência antimicrobiana de S. aureus num período de quinze anos. Metodologia: Foram analisados os testes de sensibilidade aos antimicrobianos de 720 S. aureus isolados de hemoculturas de um hospital terciário do sul do Brasil. Os dados foram obtidos do Sistema de Informação AGTA Healthcare, módulo LABHOS®. Resultados: A frequência média de S. aureus resistentes a meticilina foi de 43,74%. Com exceção de penicilina, ocorreu variação significativa da resistência para todos os antimicrobianos no período avaliado (< 0,001). Ciprofloxacina, Eritromicina e Clindamicina apresentaram os maiores índices de resistência com tendência de aumento. Surpreendentemente, Gentamicina e Sulfametoxazol-Trimetoprim apresentaram queda significativa nos percentuais de resistência. Analisando-se vancomicina do ano 2011 a 2015 pode-se evidenciar um aumento das concentrações inibitórias mínimas. Conclusão: Embora a resistência a antimicrobianos tenha aumentado nos quinze anos para a maioria dos antimicrobianos, para Sulfametoxazol-Trimetoprim e Gentamicina ocorreu redução significativa, indicando uma possível alteração clonal. Este estudo evidenciou, ainda, a emergência do fenótipo S. aureus intermediário a vancomicina.
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Gonçalves GB, Furlan JPR, Vespero EC, Pelisson M, Stehling EG, Pitondo-Silva A. Spread of multidrug-resistant high-risk Klebsiella pneumoniae clones in a tertiary hospital from southern Brazil. Infect Genet Evol 2017; 56:1-7. [PMID: 29024753 DOI: 10.1016/j.meegid.2017.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 09/29/2017] [Accepted: 10/08/2017] [Indexed: 01/27/2023]
Abstract
Klebsiella pneumoniae is among the most important pathogens found in hospitals. The emergence of multiple antibiotic resistant K. pneumoniae associated with its virulence factors is a worldwide concern and its early identification is crucial, especially for controlling the spread of emerging clones. This article reports a high prevalence of multiresistant K. pneumoniae in a university hospital in southern Brazil, harboring several virulence and β-lactamase encoding genes, including pandrug-resistant high-risk international clones belonging to the clonal group 258 (ST11, ST15, ST101, ST258, ST340 and ST874).
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Affiliation(s)
- Guilherme Bartolomeu Gonçalves
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, Brazil
| | - João Pedro Rueda Furlan
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, Brazil
| | - Eliana Carolina Vespero
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Marsileni Pelisson
- Departamento de Patologia, Análises Clínicas e Toxicológicas, Universidade Estadual de Londrina, Londrina, Paraná, Brazil
| | - Eliana Guedes Stehling
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, Brazil
| | - André Pitondo-Silva
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, Brazil.
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Vivan ACP, Rosa JF, Rizek CF, Pelisson M, Costa SF, Hungria M, Kobayashi R, Vespero EC. Molecular characterization of carbapenem-resistant Klebsiella pneumoniae isolates from a university hospital in Brazil. J Infect Dev Ctries 2017; 11:379-386. [DOI: 10.3855/jidc.8614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 08/08/2016] [Indexed: 10/31/2022] Open
Abstract
Introduction: The emergence of Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-Kpn) isolates is attracting significant attention in nosocomial infection settings. K. pneumoniae is the main pathogen that harbours blaKPC genes.
Methodology: This study evaluated 54 K. pneumoniae carbapenem-resistant isolates from patients hospitalized at the University Hospital of Londrina, between July 2009 and July 2010. The isolates were phenotypically screened for carbapenemase production and submitted for genotypic confirmation by polymerase chain reaction (PCR) for KPC, metallo-β-lactamases, OXA-48, and extended-spectrum beta-lactamase genes. The absence of outer membrane proteins (OMP) was investigated by SDS-PAGE. The susceptibility profile was determined by broth microdilution, according to Clinical and Laboratory Standards Institute protocol.
Results: All isolates were phenotypically positive for class A carbapenemase production, but negative for metallo-β-lactamase activity. PCR analysis demonstrated that all isolates carried blaKPC genes and sequencing showed that all strains belonged to KPC-2 subtype. Four strains did not show porin expression, and all isolates were resistant to ertapenem, meropenem, and imipenem. Susceptibility rates reached 35.2% for gentamicin, 85.2% for polymixyn B, 87% for colistin, and 98.1% for both tigecycline and fosfomycin. Pulsed-field gel electrophoresis showed six clones, and three of them predominated among the isolates.
Conclusions: KPC-2-producing K. pneumoniae is becoming predominant among carbapenem-resistant K. pneumoniae isolates at the hospital. The association of the enzyme KPC with other resistance determinants, such as loss of porins, may increase the severity of the situation of nosocomial infections. There is an urgent need to develop strategies for infection control and prevention.
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Takashina FH, Galvão TC, Moraes LSD, Oliveira ACID, Matos CMD, Moreira D, Perugini MRE, Marroni FEC, Pelisson M, Carrilho C, Vespero EC. Outbreak of Klebsiella pneumoniae Carbapenemase-Producing Providencia stuartii in a University Hospital in Brazil. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Eliana Carolina Vespero
- Professor of Microbiology at Londrina State University, Londrina State University, Londrina, Brazil
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Kerbauy G, Vivan ACP, Simões GC, Simionato AS, Pelisson M, Vespero EC, Costa SF, Andrade CGTDJ, Barbieri DM, Mello JCP, Morey AT, Yamauchi LM, Yamada-Ogatta SF, de Oliveira AG, Andrade G. Effect of a Metalloantibiotic Produced by Pseudomonas aeruginosa on Klebsiella pneumoniae Carbapenemase (KPC)-producing K. pneumoniae. Curr Pharm Biotechnol 2016; 17:389-97. [PMID: 26891742 DOI: 10.2174/138920101704160215171649] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 08/05/2015] [Accepted: 11/23/2015] [Indexed: 11/22/2022]
Abstract
Multidrug-resistant organisms (MDRO) are a great problem in hospitals, where thousands of people are infected daily, with the occurrence of high mortality rates, especially in infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-producing Kpn). The challenge is to find new compounds that can control KPC producing-Kpn infections. The aim of this study was to evaluate the antibiotic activity of the F3d fraction produced by the Pseudomonas aeruginosa LV strain against clinical isolates of KPC-producing Kpn. The results showed that the minimum inhibitory concentration of F3d (62.5 µg mL(-1)), containing an organic metallic compound, killed planktonic cells of KPC-producing Kpn strains after 30 min of incubation. At the same concentration, this fraction also showed an inhibitory effect against biofilm of these bacteria after 24 h of incubation. Treatment with the F3d fraction caused pronounced morphological alterations in both planktonic and biofilm cells of the bacteria. The inhibitory effect of the F3d fraction seems to be more selective for the bacteria than the host cells, indicating its potential in the development of new drugs for the treatment of infections caused by KPC-producing Kpn and other MDRO.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Galdino Andrade
- Department of Microbiology, Londrina State University, CEP: 86051-990, Londrina, Brazil.
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Carrara-Marroni FE, Cayô R, Streling AP, da Silva ACR, Palermo RL, Romanin P, Venâncio E, Perugini MRE, Pelisson M, Gales AC. Emergence and spread of KPC-2-producing Pseudomonas aeruginosa isolates in a Brazilian teaching hospital. J Glob Antimicrob Resist 2015; 3:304-306. [DOI: 10.1016/j.jgar.2015.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 07/02/2015] [Accepted: 07/04/2015] [Indexed: 11/27/2022] Open
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Tavares ER, Azevedo CS, Panagio LA, Pelisson M, Pinge-Filho P, Venancio EJ, Barros TF, Yamada-Ogatta SF, Yamauchi LM. Accurate and sensitive real-time PCR assays using intergenic spacer 1 region to differentiate Cryptococcus gattii sensu lato and Cryptococcus neoformans sensu lato. Med Mycol 2015; 54:89-96. [PMID: 26392390 DOI: 10.1093/mmy/myv078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/14/2015] [Indexed: 12/21/2022] Open
Abstract
In this work, two accurate and sensitive real-time polymerase chain reaction (PCR) assays to differentiate pathogenic Cryptococcus gattii sensu lato (s.l.) and C. neoformans sensu lato (s.l.) targeting the intergenic spacer 1 (IGS1) region from rDNA locus were developed. Specific primers were designed based on their IGS1 sequence analyses and the optimal real-time PCR assays showed that the dissociation curves generated two different melting peaks, at 82.8 and 84.2ºC for C. gattii s.l. and C. neoformans s.l., respectively. No amplifications were observed in the negative template control. The minimum limit of detection of both primers was 100 plasmid copies per reaction, and they were highly specific when tested with a range of fungal DNAs. Overall, the results showed that the designed primers completely differentiated C. gattii s.l. and C. neoformans s.l. from clinical and environmental sources with great accuracy when compared to phenotypic identification, with no cross-reactivity to other fungal DNA.
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Affiliation(s)
| | | | - Luciano Aparecido Panagio
- Departamento de Microbiologia, Ciências Biológicas, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Marsileni Pelisson
- Departamento de Patologia Aplicada, Análise Clínicas e Toxicológicas, Centro de Ciências da Saúde, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Phileno Pinge-Filho
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Emerson José Venancio
- Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Tânia Fraga Barros
- Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Sueli Fumie Yamada-Ogatta
- Departamento de Microbiologia, Ciências Biológicas, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Lucy Megumi Yamauchi
- Departamento de Microbiologia, Ciências Biológicas, Universidade Estadual de Londrina, Londrina, PR, Brazil
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Ramos PIP, Picão RC, Almeida LGPD, Lima NCB, Girardello R, Vivan ACP, Xavier DE, Barcellos FG, Pelisson M, Vespero EC, Médigue C, Vasconcelos ATRD, Gales AC, Nicolás MF. Comparative analysis of the complete genome of KPC-2-producing Klebsiella pneumoniae Kp13 reveals remarkable genome plasticity and a wide repertoire of virulence and resistance mechanisms. BMC Genomics 2014; 15:54. [PMID: 24450656 PMCID: PMC3904158 DOI: 10.1186/1471-2164-15-54] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 12/26/2013] [Indexed: 11/24/2022] Open
Abstract
Background Klebsiella pneumoniae is an important opportunistic pathogen associated with nosocomial and community-acquired infections. A wide repertoire of virulence and antimicrobial resistance genes is present in K. pneumoniae genomes, which can constitute extra challenges in the treatment of infections caused by some strains. K. pneumoniae Kp13 is a multidrug-resistant strain responsible for causing a large nosocomial outbreak in a teaching hospital located in Southern Brazil. Kp13 produces K. pneumoniae carbapenemase (KPC-2) but is unrelated to isolates belonging to ST 258 and ST 11, the main clusters associated with the worldwide dissemination of KPC-producing K. pneumoniae. In this report, we perform a genomic comparison between Kp13 and each of the following three K. pneumoniae genomes: MGH 78578, NTUH-K2044 and 342. Results We have completely determined the genome of K. pneumoniae Kp13, which comprises one chromosome (5.3 Mbp) and six plasmids (0.43 Mbp). Several virulence and resistance determinants were identified in strain Kp13. Specifically, we detected genes coding for six beta-lactamases (SHV-12, OXA-9, TEM-1, CTX-M-2, SHV-110 and KPC-2), eight adhesin-related gene clusters, including regions coding for types 1 (fim) and 3 (mrk) fimbrial adhesins. The rmtG plasmidial 16S rRNA methyltransferase gene was also detected, as well as efflux pumps belonging to five different families. Mutations upstream the OmpK35 porin-encoding gene were evidenced, possibly affecting its expression. SNPs analysis relative to the compared strains revealed 141 mutations falling within CDSs related to drug resistance which could also influence the Kp13 lifestyle. Finally, the genetic apparatus for synthesis of the yersiniabactin siderophore was identified within a plasticity region. Chromosomal architectural analysis allowed for the detection of 13 regions of difference in Kp13 relative to the compared strains. Conclusions Our results indicate that the plasticity occurring at many hierarchical levels (from whole genomic segments to individual nucleotide bases) may play a role on the lifestyle of K. pneumoniae Kp13 and underlie the importance of whole-genome sequencing to study bacterial pathogens. The general chromosomal structure was somewhat conserved among the compared bacteria, and recombination events with consequent gain/loss of genomic segments appears to be driving the evolution of these strains.
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Ramos PIP, Picão RC, Vespero EC, Pelisson M, Zuleta LFG, Almeida LGP, Gerber AL, Vasconcelos ATR, Gales AC, Nicolás MF. Pyrosequencing-based analysis reveals a novel capsular gene cluster in a KPC-producing Klebsiella pneumoniae clinical isolate identified in Brazil. BMC Microbiol 2012; 12:173. [PMID: 22882772 PMCID: PMC3438125 DOI: 10.1186/1471-2180-12-173] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 05/23/2012] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND An important virulence factor of Klebsiella pneumoniae is the production of capsular polysaccharide (CPS), a thick mucus layer that allows for evasion of the host's defense and creates a barrier against antibacterial peptides. CPS production is driven mostly by the expression of genes located in a locus called cps, and the resulting structure is used to distinguish between different serotypes (K types). In this study, we report the unique genetic organization of the cps cluster from K. pneumoniae Kp13, a clinical isolate recovered during a large outbreak of nosocomial infections that occurred in a Brazilian teaching hospital. RESULTS A pyrosequencing-based approach showed that the cps region of Kp13 (cpsKp13) is 26.4 kbp in length and contains genes common, although not universal, to other strains, such as the rmlBADC operon that codes for L-rhamnose synthesis. cpsKp13 also presents some unique features, like the inversion of the wzy gene and a unique repertoire of glycosyltransferases. In silico comparison of cpsKp13 RFLP pattern with 102 previously published cps PCR-RFLP patterns showed that cpsKp13 is distinct from the C patterns of all other K serotypes. Furthermore, in vitro serotyping showed only a weak reaction with capsular types K9 and K34. We confirm that K9 cps shares common genes with cpsKp13 such as the rmlBADC operon, but lacks features like uge and Kp13-specific glycosyltransferases, while K34 capsules contain three of the five sugars that potentially form the Kp13 CPS. CONCLUSIONS We report the first description of a cps cluster from a Brazilian clinical isolate of a KPC-producing K. pneumoniae. The gathered data including K-serotyping support that Kp13's K-antigen belongs to a novel capsular serotype. The CPS of Kp13 probably includes L-rhamnose and D-galacturonate in its structure, among other residues. Because genes involved in L-rhamnose biosynthesis are absent in humans, this pathway may represent potential targets for the development of antimicrobial agents. Studying the capsular serotypes of clinical isolates is of great importance for further development of vaccines and/or novel therapeutic agents. The distribution of K-types among multidrug-resistant isolates is unknown, but our findings may encourage scientists to perform K-antigen typing of KPC-producing strains worldwide.
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Viana G, dos Santos Saalfeld S, Garcia L, Cardoso C, Pelisson M, Tognim M. Evolution of antimicrobial resistance of Acinetobacter baumannii in a university hospital. Lett Appl Microbiol 2011; 53:374-8. [DOI: 10.1111/j.1472-765x.2011.03109.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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